As the locus of patient care shifts from hospitals to the ambulatory setting, primary care practices have become increasingly important as a research focus. In 1997, the American Society of Internal Medicine (ASIM) established QNet, a national practice-based research network of internists. Its original objectives were to reinforce best practices, to assess how closely members follow best practices, and to understand physicians’ reasons for non-compliance with clinical practice guidelines. With the merger between ASIM and the American College of Physicians, QNet membership grew to more than 400 physicians. By 2000, 137 QNet physicians completed five best practice studies on chronic common conditions: diabetes, cholesterol screening, congestive heart failure, asthma, and warfarin treatment. Results from these studies were analyzed both quantitatively and qualitatively; quantitative analysis elucidated areas of patient care that were sub-optimal, while qualitative analysis captured barriers to following clinical practice guidelines and achieving optimal care. An evaluation study has also been completed to assess the progress of this network. QNet is now launching three new initiatives: a regional primary care diabetes quality improvement project, a national diabetes pharmacological management project, and a national study on the management of the first incident of deep venous thrombosis/pulmonary embolism. In this session, we will present QNet methodology, results, and lessons learned. We will also discuss the value of PBRNs in translating research into practice, identifying barriers to clinical practice guideline implementation, and the use of the PBRN model to improve practice quality.

Learning Objectives: At the conclusion of this session, the participant will be able to

Discuss the value of PBRNs in clinical research;

Articulate the barriers to practice-based research and methods to overcome them.

Keywords: Quality of Care, Primary Care

Presenting author's disclosure statement:Organization/institution whose products or services will be discussed: American College of Physicians-American Society of Internal MedicineI have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.Relationship: Employment